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Housing Exemption Form
Full Name
*
First Name
Last Name
Student ID number
*
Email (STU)
*
example@stu.edu
Email (Personal)
*
example@gmail.com
Phone Number
*
.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please check the Reason for your Housing Exemption.
*
Please Select
Live within 12 miles
Legally Married
21 or older
Medical Condition
60 Credits or more
Please explain any additional special circumstances that will assist the Office of Residence Life & Community Standards while considering your request.
Please sign that all of the information provided are true.
*
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